TEN09-08a5.pdf

ETA Advisory File Text

ATTACHMENT E SOURCE DOCUMENTATION REQUIREMENTS FOR PROGRAM YEAR PY 2006 NFJP DATA ELEMENT VALIDATION E.2 This appendix presents the data elements to be validated with their associated WIASPR number element definitions valid values federal validation sources state grantee sources and validation instructions needed to perform data element validation. The federal sources are the generic federally recommended source documentation. The State Grantee Sources column can be used to enter grantee- specific versions of the federally approved documentation. Two types of validation rules exist 1. If the validation instruction cell says MATCH Enter a checkmark in the box in the pass column if the data on the validation worksheet match the data in the source documentation. Enter a checkmark in the box in the fail column if the data on the worksheet do not match the data in the source documentation or if no source documentation is found. To match the data on the worksheet must be the same as the data in the source documentation. For example if the worksheet says a participant s date of birth is July 1 1975 then the source documentation must also have July 1 1975 as the birth date. 2. If the validation instruction says SUPPORT Enter a checkmark in the box in the pass column if the data on the validation worksheet are supported by the data in the source documentation. Enter a checkmark in the box in the fail column if the data on the worksheet are not supported by the data in the source documentation or if no source documentation is found. To support the data on the worksheet must be similar to the data in the source documentation. This instruction is used when information must be interpreted or processed before it can be applied to the participant s records. For example source documentation can support farmworker status in different ways by a code or narrative or other information. For the most part the definition of a particular source is clear. Grantees may however have questions about three sources Grantee Management Information System MIS Self-Attestation and Case Notes. Definitions for these three types of source documentation are E.3 1. MIS Unless otherwise noted MIS refers to specific detailed information which supports an element that is stored in the grantee s information system. An indicator alone such as a checkmark on a computer screen is not acceptable source documentation. For example a grantee s MIS is acceptable source documentation for date of exit if it identifies the last service received in addition to the date on which that service was received. 2. Self-Attestation Self-attestation occurs when a participant states his or her status for a particular data element and then signs and dates a form acknowledging this status. The key elements for self-attestation are a the participant identifying his or her status for permitted elements and b the signing and dating of a form attesting to this self-identification. The form and signature can be on paper or in the state management information system with an online signature. 3. Case Notes Case notes refer to either paper or electronic statements by the case manager that identifies at a minimum the following a participant s status for a specific data element the date on which the information was obtained and the case manager who obtained the information. E.4 WIASPR Item Name and Number Data Element Definition Valid Values Federal Sources State Grantee Sources Instructions 4. Date of Participation Record the date on which the individual begins receiving his her first service funded by the program following a determination of eligibility to participate in the program. YYYYMMDD Grantee Administrative Records Match 5. Date of Birth Record the individual s date of birth. YYYYMMDD Family bible birth certificate passport driver s license baptismal record I-9 form Match 9. Qualifies for Sec. 167 Program as a Record appropriate status of the participant. SPECIAL NOTE If a participant qualifies as eligible under both categories use Code 1 Farmworker. 1 Farmworker 2 Dependent or Spouse of a Farmworker Pay stubs W-2 forms IRS 1040 forms case manager counselor intake notes self attestation Support 11. Farmworker Status Use the appropriate code to record the status of the participant at the time of eligibility determination. SPECIAL NOTE Where participant is a dependent of a farmworker record the status of the eligible farmworker. 1 Migrant Farmworker 2 Seasonal Farmworker Pay stubs W-2 forms IRS 1040 forms case manager counselor intake notes self attestation Support 13b. Number of Individuals in the Family Record the total number of individuals in the family including the participant. 00 Birth certificate family bible IRS 1040 forms Match E.5 WIASPR Item Name and Number Data Element Definition Valid Values Federal Sources State Grantee Sources Instructions 16. Employment Status at Participation Record 1 if the participant is a person who either a did any work at all as a paid employee b did any work at all in his or her own business profession or farm c worked 15 hours or more as an unpaid worker in an enterprise operated by a member of the family or d is one who was not working but has a job or business from which he or she was temporarily absent because of illness bad weather vacation labor-management dispute or personal reasons whether or not paid by the employer for time off and whether or not seeking another job. Record 2 if the participant is a person who although employed either a has received a notice of termination of employment or the employer has issued a Worker Adjustment and Retraining Notification WARN or other notice that the facility or enterprise will close or b is currently on active military duty and has been provided with a date of separation from military service. Record 3 if the participant does not meet any one of the conditions described above. 1 Employed 2 Employed but Received Notice of Termination of Employment or Military Separation 3 Not Employed Pay stub case notes showing information collected from participant Support E.6 WIASPR Item Name and Number Data Element Definition Valid Values Federal Sources State Grantee Sources Instructions 17. Six Month Pre-Program Earnings Record the total pre-program earnings of the participant for the 6-month period prior to the date of application in the program. Earnings include salaries or wages and also include any bonuses tips gratuities and commissions or overtime pay earned. Record 00000 if there were no earnings during this period. 00000 Pay stubs W-2 forms employer payroll records IRS 1040 forms administrative UI wage records self attestation detailed case management notes Match 21e. Long-term Agricultural Employment Record 1 if the participant is a person who has engaged in agricultural work as the primary source of income for a minimum of four 4 years prior to intake eligibility determination. Record 2 if the participant does not meet the conditions described above. 1 Yes 2 No IRS 1040 forms pay stub intake application case manager counselor progress notes self- attestation Support 24. Date of First Intensive Service Record the date on which the participant first received intensive services. Intensive services include specialized assessments of skill levels work experience diagnostic testing adult basic education or English as a Second Language ESL training development of an individual employment plan group or individual counseling case management for participants seeking training services short-term prevocational services and remedial reading writing or communication skills training. Otherwise leave blank if the participant did not receive intensive services. YYYYMMDD Case manager counselor progress notes with signature IEP assessment and diagnostic testing Match E.7 WIASPR Item Name and Number Data Element Definition Valid Values Federal Sources State Grantee Sources Instructions 25. Date of First Training Service Record the date on which the participant first received training services. Training services include but are not limited to occupational skills training OJT skill upgrading entrepreneurial training and job readiness training. Otherwise leave blank if the participant did not receive training services. YYYYMMDD Case manager counselor certification signature employer signed document attendance records from institution or instructor Match 33. Date of Exit Record the date on which the last service funded by the program or a partner program is received by the participant. Once a participant has not received any services funded by the program or a partner program for 90 consecutive calendar days and has no gap in service and is not scheduled for future services the date of exit is applied retroactively to the last day on which the individual received a service funded by the program or a partner program. YYYYMMDD Case manager counselor termination notice case manager counselor progress tracking report grantee MIS Match E.8 WIASPR Item Name and Number Data Element Definition Valid Values Federal Sources State Grantee Sources Instructions 34. Category of Exit Record 1 if the participant received and or completed any job-related core beyond core informational or self-services and eligibility determination intensive or training services. Record 2 if the participant received non- job related services without having received job-related core intensive or training services. Record 3 if the participant did not complete the program and exited for other reasons as specified in Item 35 below. SPECIAL NOTE Individuals who receive training-related services AND intensive or training services should be coded 1. 1 Employment and Training Exiter 2 Related Assistance Services ONLY Exiter 3 Other Reasons for Exit Grantee administrative records Support E.9 WIASPR Item Name and Number Data Element Definition Valid Values Federal Sources State Grantee Sources Instructions 35. Other Reasons for Exit at time of exit or during 3-quarter measurement period following the quarter of exit Record 1 if the participant is residing in an institution or facility providing 24-hour support such as a prison or hospital and is expected to remain in that institution for at least 90 days. Record 2 if the participant is receiving medical treatment that precludes entry into unsubsidized employment or continued participation in the 167 program. Does not include temporary conditions expected to last for less than 90 days. Record 3 if the participant was found to be deceased or no longer living. Record 4 if the participant entered advanced training. Advanced training includes an occupational skills employment training program not funded under Title I of WIA which does not duplicate training received under Title I. This category includes only training outside of the 167 program One-Stop WIA and partner system. Record 5 if the participant entered post- secondary education. Post-secondary education includes a program at an accredited degree-granting institution that leads to an academic degree e.g. AA AS BA BS . This does not include entry into post-secondary education programs offered by degree-granting institutions that do not lead to an academic degree. 1 Institutionalized 2 Health Medical 3 Deceased 4 Entered Advanced Training 5 Entered Post- Secondary Education 6 Moved Cannot Locate Voluntary Separation 7 Family Care 8 Reserve Forces Called to Active Duty 9 Not a Valid SSN Grantee administrative records Support E.10 WIASPR Item Name and Number Data Element Definition Valid Values Federal Sources State Grantee Sources Instructions 35. Other Reasons for Exit continued Record 6 if the participant cannot be located or has moved to an area that prevents them from completing their program or has voluntarily left the program. Record 7 if the participant is providing care for a family member with a health medical condition that precludes entry into unsubsidized employment or continued participation in the program. Does not include temporary conditions expected to last for less than 90 days. Record 8 if the participant is a member of the National Guard or other reserve military unit and is called to active duty for at least 90 days. Record 9 if the social security number of the participant is not valid. Record 0 or leave blank if the participant exited for a reason other than one of the conditions described above. 36. Date Placed in Unsubsidized Employment Record the date on which the participant was placed into unsubsidized employment. Leave this field blank if the participant did not enter unsubsidized employment. YYYYMMDD Case manager counselor progress notes Match E.11 WIASPR Item Name and Number Data Element Definition Valid Values Federal Sources State Grantee Sources Instructions 41. Employed in the 1 st Quarter After Exit Quarter Record 1 if the participant was employed in the first quarter after the quarter of exit. Record 2 if the participant was not employed in the first quarter after the quarter of exit. Record 3 if information on the participant s employment status in the first quarter after the quarter of exit is not yet available. 1 Yes 2 No 3 Information Not Yet Available Pay stubs employer payroll records IRS 1040 forms case manager counselor progress notes self- attestation Support 42. Employed in the 2 nd Quarter After Exit Quarter Record 1 if the participant was employed in the second quarter after the quarter of exit. Record 2 if the participant was not employed in the second quarter after the quarter of exit. Record 3 if information on the participant s employment status in the second quarter after the quarter of exit is not yet available. 1 Yes 2 No 3 Information Not Yet Available Pay stubs employer payroll records IRS 1040 forms case manager counselor progress notes self- attestation Support 43. Employed in the 3 rd Quarter After Exit Quarter Record 1 if the participant was employed in the third quarter after the quarter of exit. Record 2 if the participant was not employed in the third quarter after the quarter of exit. Record 3 if information on the participant s employment status in the third quarter after the quarter of exit is not yet available. 1 Yes 2 No 3 Information Not Yet Available Pay stubs employer payroll records IRS 1040 forms case manager counselor progress notes self- attestation Support E.12 WIASPR Item Name and Number Data Element Definition Valid Values Federal Sources State Grantee Sources Instructions 44. Wages 2 nd 3rd Quarters After Exit Quarter Record the total earnings earned by the participant in the second and third calendar quarters after the quarter of exit. Total earnings include any bonuses tips gratuities commissions and overtime pay earned. Note Enter whole dollar amounts 00000 . Enter 99999 if data are not yet available for this item. Otherwise leave blank if this data element does not apply. 00000 Pay stubs employer payroll records IRS tax forms administrative UI wage records case manager counselor progress notes with signature Match